February 17, 2025 • 41 mins
Join me for an enlightening conversation with Alison Patchett, @the.vag.hormone.naturopath, as we uncover the often overlooked world of vaginal health during perimenopause and menopause. Have you ever wondered why there's a stigma around discussing vaginal wellness? Alison shares her transformative journey from corporate life to her true passion: empowering women to embrace and understand their bodies. Together, we break down the barriers in discussing these intimate health topics, highlighting the common changes women experience, such as dryness and irritation, and their impact on self-confidence and sexual health.
Discover how natural solutions can make a significant difference in maintaining vaginal health. We delve into the benefits of naturopathic approaches and why targeted testing, although not covered by Medicare, can be a game-changer. From the soothing properties of sea buckthorn and flaxseed gel to simple lifestyle tweaks like what underwear to choose, we share practical tips that go a long way in promoting comfort and wellness.
Navigating the complexities of recurrent vaginal symptoms like thrush is crucial for optimal health. With Alison's expert insights, we address the misconceptions surrounding these issues and the importance of accurate diagnosis. Understanding the vaginal microbiome and the role of hormones can lead to more effective treatment plans. Our conversation emphasizes the need for women to advocate for their health confidently and underscores the value of collaboration between medical and natural health practitioners to achieve comprehensive, personalized care. Tune in as we encourage open dialogues and empower women to take charge of their vaginal health during these transitional years.
You can find Alison at thevaghormonenaturopath.com.au and if you would like her exclusive free eBook she speaks about on this episode - DM her on IG @the.vag.hormone.naturopath or email her hello@thevaghormonenaturopath.com.au
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi, I'm Susie Garden and this is the Ageless and
Awesome podcast.
I'm an age-defying naturopathand clinical nutritionist and
I'm here to bust myths aroundwomen's health and aging so that
you can be ageless and awesomein your 40s, 50s and beyond.
The Ageless and Awesome podcastis dedicated to helping women
(00:24):
through perimenopause andmenopause with great health, a
positive mindset and outrageousconfidence.
Hit, subscribe or follow nowand let's get started.
Hello, gorgeous one, andwelcome to this week's episode
of the Ageless and Awesomepodcast.
I'm really excited abouttoday's episode.
It's a topic that I don't thinkI've covered in the years that
(00:48):
I've been doing this podcast.
I don't think I've reallycovered it ever in any great
depth, and that is the health ofthe vagina.
So I'm super happy and excitedto have a vagina expert here
today in Alison Patchett.
So Alison is the Vag HormoneNaturopath.
She's dedicated to empoweringher clients not only to manage
symptoms, but also to identifyand address the underlying cause
(01:11):
of those symptoms.
As you know, with naturopathywe love getting into that
underlying cause.
She's all about empoweringevery woman to feel informed and
confident about the health oftheir vagina and hormones,
providing expert integrativesupport for women, online or in
person.
She's based in Bandura inVictoria.
Alison addresses everythingfrom hormone imbalances to
(01:34):
intimate healthcare.
Her approach is tailored to herclients' needs.
She combines advanced testing,natural therapies and lifestyle
adjustments so you can reclaimyour health and get back your
sparkle.
Alison, welcome to the Agelessand Awesome podcast.
Speaker 2 (01:50):
Thank you, susie, it's lovely to be here.
Speaker 1 (01:53):
It's lovely to have you here as well.
I guess I wanted to start offwith a little bit about you and
your journey and how you came tobe interested in this area of
specialty, and maybe a littlebit even about the type of
training that you've done.
Speaker 2 (02:07):
Yeah, sure.
So being a naturopath is asecond career for me.
So I worked in the corporatespace for quite a long time and
saw a lot of very saw a lot ofmy colleagues get very burnt out
and was very burnt out myselfand so ended up following, I
think, what was a passion for areally long time in studying
naturopathy.
(02:29):
Then, after once I startedpracticing, I found that the
sort of people I was seeing Iwas seeing a lot of hormones, a
lot of women with menstrualissues, lots of PMS symptoms,
those sorts of things, and Ithink it was sort of I guess
when I was around 41, that Istarted to kind of look into my
(02:50):
own health a little bit more andstarted to see more of those
perimenopausal hormone clientscome in and then, starting to
see lots of vaginal issues,developed an interest in that,
studied a six-month coursecalled Vagiversity, which was
just amazing, which is a realdeep dive into what's going on
(03:13):
in the vagina and lots ofdifferent presentations and
symptoms and all sorts ofwonderful bits and pieces, and
found that that was a realcalling and a real passion to
really help women in this, Ithink, really underserviced area
of healthcare andunderappreciated as well.
Speaker 1 (03:35):
Yeah, yeah, absolutely, and this is
something that I see a lot.
I used to work in a localclinic here in the Gold Coast
and the intake form there wasincredible with the amount of
depth that went into withvaginal health questions and I
thought to myself, my gosh, whenI first saw it.
No GP has ever asked me any ofthose questions proactively, and
(04:01):
it's really something that manywomen are quite hesitant to
bring up.
There is still quite a lot ofstigma around the vagina.
I mean even just and I'm sureyou've had this probably on your
social media even writing theword vagina can be censored,
like I've.
I remember doing a story withthe automated captions and it
(04:24):
actually, you know, made alittle, I don't know an asterisk
or something where the A was.
It was just like what?
Why?
is this word being censored.
It's just crazy.
So no wonder women feel kind ofhesitant to bring these sorts
of symptoms to their healthcareprovider's attention.
When there is still that levelof embarrassment, would you
(04:44):
agree that is going on?
Speaker 2 (04:45):
in this area.
Oh, totally, yes, absolutely.
I think there's a realreluctance from many women to
kind of appreciate the extent towhich some of their vaginal
health issues are impactingtheir lives and their
relationships and theirself-confidence as well.
And you know, some of myclients, you know, will start on
(05:07):
one area and I do ask aboutvaginal health and then, you
know absolutely, will be led bythe client as to how comfortable
they are talking about it.
But you know, absolutely, if wehaven't touched on it before,
certainly within the second orthird consult we are talking
about vaginal health.
Certainly within the second orthird consult we are talking
about vaginal health.
It's something we're checkingon regularly, no matter what age
(05:28):
my client is, because it issuch an important area of
healthcare that is so oftenmissed.
Speaker 1 (05:36):
Absolutely, and there are a number of health issues
that can present, I guess, inthe vagina, particularly around
that perimenopausal time.
And that's a lot about whatwe're going to talk about today,
which I'm really excited to getinto, and I guess let's just
start with the probably morewell-known symptom of
perimenopause and postmenopause,which is the dry vagina.
(05:59):
So I guess I wanted to ask youfirstly.
So I guess I wanted to ask youfirstly, what are the most
common vaginal changes womenexperience during perimenopause?
Speaker 2 (06:11):
Yeah, so dryness is probably the number one issue
that people experience.
Irritation that then leads tothings like painful sex or even
painful masturbation, whichimpacts on libido.
(06:36):
We then have othercomorbidities, I guess, or other
symptoms that go along withthat, things like prolapse or
urinary tract infections,increased urinary frequency,
which is not necessarilytechnically the vagina, but
because of the location and thecrosstalk in that area.
We can see a lot of crossoverin symptoms and misunderstanding
of symptoms.
(06:57):
Because of the location.
You know where pain might occuror where irritation or itching
might occur, and so you know, asthose estrogen levels are
changing, that you know reallypromotes those symptoms to occur
.
Speaker 1 (07:14):
Can you talk to me a little bit more about the
misunderstanding of symptoms?
Speaker 2 (07:18):
Yeah, so what I find with actually, I had a client
last week we were talking about.
They felt like they were coming,they kept getting urine retract
infections, but they'd go tothe doctor, they'd do a urine
test.
It was nothing there, you know,there was nothing being cultured
and when.
So what we did was we reallytalked quite specifically about
(07:40):
the location of where thisirritation was occurring, and I
think we don't necessarilyappreciate how close some of
that anatomy is, and so,therefore, what was being
interpreted as urinary issueswas actually further back.
So it was actually the vaginathat was painful and irritated
(08:02):
rather than the urethra wherethe urine was coming out of.
And so it wasn't until we gotinto some really detailed
questions and, you know, broughtup diagrams and did all sorts
of things to kind of really getinto that nitty gritty detail
that we properly understood.
And for this client it was like, oh, of course that makes so
(08:23):
much sense now that they kind ofunderstood a little bit more
about what was going on, and youknow that meant that we could
actually move forward with anappropriate treatment plan
rather than kind of her feelinglike she had to keep, you know,
looking at potential antibioticsor other treatments that were
just not going to be effective.
Speaker 1 (08:43):
Yes, I know that's something that I'm seeing a lot
actually, just with my ownmother is the amount of
antibiotics that she's beingprescribed for recurrent urinary
tract infections and they'rejust not going any further in
terms of you know, theunderlying cause of that and I
think that is something that isa real problem, I think, in
(09:04):
women's health is that theamount of antibiotics that are
getting thrown at these sorts ofissues rather than going well.
Okay, come on, we know theunderlying cause, which we're
going to get into in a minute.
What are we going to do aboutthat?
So let's talk about why this ishappening.
What is the underlying cause?
Why are these changes happening?
Speaker 2 (09:23):
Yeah.
So I guess estrogen is kind ofthe main culprit good or bad.
Estrogen's awesome Loveestrogen.
Estrogen and progesterone, theyare so protective in so many
ways for our body and in ways wedon't even fathom, until we get
to perimenopause and thoselevels start to shift and we
(09:44):
start to see symptoms occurring.
And so what happens in thevagina is that estrogen actually
supports the production of a,an ingredient I guess, in the
mucus layer called glycogen, andwhat the glycogen does is it
(10:06):
helps support that mucus layerto be nice and healthy and that
then supports the beneficialbacteria in the vaginal
microbiome.
So yeah, so we might.
You know many people might haveheard of the gut microbiome.
Well, our vagina has amicrobiome as well and there's
one dominant species therecalled lactobacilli.
(10:27):
And so what estrogen does is itprovides the main food source
in the mucus for that.
So in perimenopause ourestrogen levels are kind of
going a little bit all over theplace, are kind of going a
little bit all over the place.
But certainly, as they start todecline we start to see that
mucus layer thin and thatimpacts the acidity of that
(10:51):
environment, it impacts theviscosity in there.
So I guess when we think of ourvagina.
We think of it as a hollow tube, which I guess it is, but when
it's in a relaxed state itactually sits flat.
So when we're not aroused orit's not being used in any way,
then the vagina actually sitsflat.
(11:11):
So when there's less mucus, thewalls of the vagina actually
rub against each other and thatcan cause irritation and that
can be quite painful, and sothat's kind of then leads to
further symptoms.
Speaker 1 (11:27):
Yeah, and so in terms of testing, I know you can test
the pH, for example, of thevagina and there's vaginal
microbiome testing.
Can you talk a little bit abouteach of those?
Speaker 2 (11:40):
Yeah, yeah.
So pH testing, I think, isincredibly.
It's a really easy way ofkeeping in touch with what's
going on in the microbiome.
So through perimenopause,because of those changes in the
mucus layer, we do see the pHmove from a more acidic pH of
between 3.5 and 4.5 and movesort of up to the higher end, up
(12:04):
to above 4.5, which is lessthan ideal, I guess.
And the vaginal pH test stripkits that you can get you can
get them online, you can getthem at some chemists.
That's a really good way ofbeing able to check in and see
what's going on in the vagina,because often what we see is the
presentation of symptomsfollows a rise in that vaginal
(12:26):
pH.
So that's actually for someonethat gets symptoms regularly,
that's actually a really niceway of kind of being able to
check and see what's going on ona more regular basis.
The vaginal test kit so there'squite a few different options
around, both here in Australiaand from overseas, and what
(12:48):
they're doing is often they arechecking the pH, but they're
going into a lot more detail.
So they're actually looking atthe flora that makes up that
vaginal microbiome.
So they're looking for thelactobacilli.
What type of lactobacilli?
They're looking for candidaspecies.
They're looking for otheropportunistic bacteria.
So if there are symptomsoccurring, so whether that's
(13:11):
itching or dryness or discharge,or smell or discomfort or
whatever it might be, we cantest that and we can see what's
going on more specifically, sowe can get to, we can be a lot
more targeted in the treatmentwhile we're addressing the root
cause of why that's happened inthe first place.
Speaker 1 (13:34):
Yeah, it's so good to have these tools available to
us, but generally you'reprobably not going to get
recommended to do that by the GP.
I think it's more thenaturopathic profession that's
kind of leading the way in thisaspect.
I mean, unfortunately, they arethings that you have to pay for
.
There's no Medicare coveragefor any of that kind of testing,
(13:56):
but it can make a bigdifference to have the knowledge
of exactly what you need tomanipulate, I guess, in the
microbiome, rather than justtaking a bit of a guess.
Yes absolutely yeah that'sabsolutely right.
Speaker 2 (14:11):
Yeah, I mean the more information you know.
Knowledge is power, so the moreinformation we have, the better
results that everyone's goingto get.
Speaker 1 (14:18):
Yeah, exactly, you're not going to waste, I guess,
time and money throwing thingsat it that maybe aren't going to
be as targeted and not going toget you that faster result.
And when you're talking aboutvaginal health, I mean it's very
uncomfortable to be havingthose sorts of irritated
symptoms.
I can imagine it'd be verydistracting probably a lot of
the time if you're at yourworkplace or you're trying to
(14:41):
enjoy life and you've got thesedistracting symptoms.
If you can get on top of it asquickly as possible, it really
improves quality of life, I canimagine, quite substantially.
Speaker 2 (14:52):
Yes, definitely, and I think for many women that put
up with those symptoms for sucha long time.
We don't want to muck around,we want to get on top of it.
Yeah, exactly.
Speaker 1 (15:01):
So you know, we've got these symptoms, we've got
the testing.
So what then?
Treatment options are availablespecifically for this, you know
, menopausal or perimenopausaldry vagina.
Speaker 2 (15:13):
Yeah, there's a couple of things that I use
quite regularly.
Sea buckthorn is something thatI use a lot of in this age
group.
I think it's such a it's abeautiful way of really being
able to support yourself, andwhat I really like about it is,
alongside other herbalinterventions, to look at what's
(15:33):
going on with, you know,supporting hormone balance and
things like that.
Sea buckthorn oil is somethingthat often my clients will use,
you know, daily for a couple ofmonths and then we'll start
tapering it back.
Speaker 1 (15:44):
Yeah, and that's applied into the area, right,
it's not?
Speaker 2 (15:47):
something you can take it orally.
Speaker 1 (15:48):
You can take it orally, so it depends on the
level of inflammation that'sgoing on.
Speaker 2 (15:52):
So sometimes I'll use fennel oil, like in a cream or
something like that, topically.
Sometimes we'll use the seabuckthorn oil topically and
orally.
So you know we might go okay,well, let's do your whatever
dose and, you know, do fivedrops and wipe that over the
vagina with a clean hand andtake the rest orally or whatever
it might be that suits thatparticular person and that
(16:13):
presentation, because that canmake a really big difference to
the itching and dryness and Ifind that working internally
while alongside of a hormonebalancing is just.
You know, it's a beautifulcombination that's really
settling.
I've also had a few clientsmake up their own flaxseed gel,
so I give them.
I've got a recipe that I giveto my clients.
(16:36):
Yeah, which is it's beautiful.
Actually, it can be usedtopically to kind of soothe
irritation and itching, but itcan also be used as a lubricant.
It can be used topically tokind of soothe irritation and
itching, but it can also be usedas a lubricant.
It can also be used as a hairgel, but most of my clients
don't use it for that.
It's more the lubricant and thesoothing aspect of it that
we're looking for.
But, yeah, it's a really nicething that they can make up
(16:59):
themselves at home.
Use this, you know, as theyneed it.
Yeah, and you know, obviously.
You know from a diet andlifestyle perspective.
You know we want to look atwhat's going on hygiene wise in
that area as well.
It's going to irritate thevagina, so we don't want any.
(17:29):
You know vaginal sprays orharsh soaps, or you know even
things like looking at what typeof underwear people are wearing
, or are they, you know, goingto the gym and getting really
sweaty but not changing theirclothes for a really long time
All of those sorts of littlebits and pieces make a really
big difference to how that areaof the body is actually feeling.
Speaker 1 (17:46):
Yeah and it's true, isn't it Like with the rise of
active wear as an all day kindof attire?
And, yes, I can imagine manywomen are going to the gym,
maybe particularly here inQueensland where it is very hot.
So you know even if you getchanged and have a shower, if
you're throwing active wear backon and it's you know they're
(18:07):
generally not made of naturalfibres and you're sweating
during the day, it's not reallya well.
Actually, it is an idealenvironment for not so good
bacteria to thrive and fungusand all of that sort of thing.
But yeah, I can imagine that'snot ideal and it's maybe not
something people are reallythinking about.
Speaker 2 (18:24):
Yeah, I think, yeah, I think there is often some
little changes that people canmake, like including flax seeds
in their diet, like wearingcotton underwear, like you know,
using water to clean theirvagina rather than any, you know
, special perfumes or whatever,or soaps, and those little
changes can make a really bigdifference.
Speaker 1 (18:46):
Do you find that many women are using different sort
of I'll call it chemicals,because that's generally what
they are in that area with aview to deodorizing or the
hygiene, that kind of thing?
Are you finding that there'scertainly?
I know we're probably a similarvintage.
As a teen and in my 20s thoseproducts didn't exist.
(19:08):
No, I know, you know it didn'texist.
It's not even a thought thatthat was a necessary kind of
product.
So you know, are you findingthat women are tending to use
that, or maybe it's more intheir 30s now that are probably
going to come into perimenopausein the next 10 years, that
might be using them more?
What are you finding?
Speaker 2 (19:27):
I think it's both.
I think what I find is thatwomen with vaginal dryness don't
necessarily recognize it asdryness.
They recognize it as itchingand irritation, and therefore
there's a lot of confusion overwhat is actually driving those
symptoms.
And therefore they're using youknow, they might be using
(19:48):
thrush treatments, or they mightbe using, you know, a body
spray or a you know, a vaginalcream that's, you know, just
from the chemist that's full offragrances and all sorts of
things that is actuallydisrupting the natural flora.
That's going on there and, andwhile some of them might provide
(20:10):
a little bit of short-termrelief, they're actually making
the problem worse in the longerterm yeah, yeah, because I guess
too, in fairness, like weprobably didn't even know that
the vaginal microbiome existedwhen those products first came
out.
Speaker 1 (20:26):
So yeah, and I think probably a lot of women still
don't know that we have aseparate microbiome down there
that needs to be looked after sothat you're getting kind of the
best health possible for yourvagina and for that longer-term
health as well.
Yeah, definitely, yeah.
So we've talked about treatmentoptions.
(20:48):
What about you know how canwomen advocate for themselves
when they're seeking help forvaginal symptoms?
Speaker 2 (20:54):
Yeah, I think this is a really big one for me and it
comes back to some of the thingsthat we were talking about you
know at the start of thisconversation about.
You know if your GP or yourhealthcare practitioner has
never asked about vaginal health, then you know that can make it
really really difficult forwomen to feel comfortable in
(21:17):
approaching that conversation.
So I think advocating foryourself is really about being
confident that you are theexpert on what's going on in
your body and that if a medicalpractitioner, no matter what
type of practitioner they are,if they dismiss those symptoms
(21:38):
without testing, withoutinvestigating, without asking
questions, then it's time tohave a look for another
practitioner, because we do needto take this seriously, you
know, as seriously as we take abroken arm or, you know,
whatever else might be acomplaint or a symptom that's
happening on the body is.
So many instances I hear ofwomen going to a healthcare
(22:03):
professional and being thrownsome cream with no, you know, no
testing, no questions kind ofasked, no detail being looked
into and of course that's notgoing to work.
So it's really about sayingthis is impacting me, this is
impacting me in these ways.
I need this taken seriously,absolutely, and having the
(22:25):
confidence in them that theyknow their own body better than
anyone else and really, yeah,that self-care aspect is really
about being confident to say Iknow what I'm talking about here
.
Speaker 1 (22:40):
Yeah, and you know, in defense of GPs, we know, and
they seem to be more openlytalking about the fact that, in
terms of menopause andperimenopause, in their entire
training they probably have onehour.
Oh, it's crazy, yeah.
So often they don't know whatto do.
Speaker 2 (22:58):
Yeah that's right.
That's right.
I mean, I have a female GPmyself and so she has asked
about vaginal health in the past, and so that opens up that
conversation.
But I've all equally spoken toclients who haven't had that
been fortunate enough to havethat conversation, but I've all
equally spoken to clients whohaven't been fortunate enough to
(23:18):
have that experience.
So it really is about findingthe right practitioner.
Speaker 1 (23:22):
It is and also, I guess, booking the right
appointment length, because Ithink that's another thing in
terms of how the GP works withtheir patients is they have a
very limited time and I'm veryexcited as we're recording this
podcast.
This week, the government hasannounced some very exciting
changes in the way menopausecare is being funded and that
(23:43):
they will be funding for longerconsults for menopause
discussions, which is great.
I mean, obviously you need tofind a GP that has menopause
training in order to actuallyget a solution, but as and also
saying that you know you're notnecessarily going to get
microbiome testing or pH testingfrom the GP, because they may
(24:04):
not just have that training.
So sometimes you need to haveboth type of practitioner to the
natural health practitionerthat has that training, uh, as
well as the medical practitioner, so that you can get kind of
both sides of the support thatmay be needed for that kind of
(24:26):
health.
Because, obviously naturopathsdon't do physical examination of
that area, so you know thereare some.
We don't do pap smears, wedon't do all of that sort of
stuff, so you do definitely needto have a practitioner that can
do that aspect.
But yeah, that's not.
So, yeah, having both.
I think if you've got the, findthe right one.
Speaker 2 (24:48):
It makes the world of difference.
And that's why I really lovewhat we do is because we work
hand in hand with whatever teamthat person's you know the
person sitting in front of usputs together.
We can work within that, thatscope.
You know there's so much.
You know I have clients who areon, you know, hrt or you know
(25:12):
doing all sorts ofpharmaceutical treatments, and
we can work really wellalongside that.
Equally, if someone doesn'twant to go down that path and
wants to try herbal supportfirst, then absolutely we can do
that.
It's about working in thecontext of what's right for that
person and there's no oneanswer to that.
Yeah, no matter what we'redoing, there's always room to
(25:35):
work side by side with GPs andgynecologists and you know
whoever else is on that person'smedical team for sure.
Speaker 1 (25:43):
Yeah, awesome, yeah.
And that's what I like to makereally clear, because I think
sometimes, as natural healthpractitioners, we can come
across as beinganti-conventional medicine, but
generally speaking, that is notthe case and, as you so
beautifully said, alison, we canwork hand in hand with whatever
team the client or the patientwould like to have on their team
(26:06):
, because the more, I guess,informed and educated
practitioners you have availableto you, hopefully you'll get
the ultimate outcome, which isoptimal health.
Yeah, so I wanted to change tacka little bit and let's talk
about thrush, because thrush is,I think, something that people
(26:28):
are more aware of.
I think they potentially aremore comfortable discussing it
because it does seem to besomething that's just so common
and many women have it at allstages of their life.
So if they've been havingepisodes of thrush since their
20s, it because it does seem tobe something that's just so
common and many women have it atall stages of their life.
So if they've been havingepisodes of thrush since their
20s, generally they're very,very comfortable going down to
the pharmacy and asking thepharmacist for treatment or
talking to their doctor.
I feel like that's probably,for whatever reason, has a bit
(26:50):
less stigma attached.
I don't know if that's yourexperience, but it seems to be
mine.
So if we can talk aboutrecurrent thrush, which does
start to occur in this age groupof peri and postmenopause, can
we talk about?
You know, the importance oftesting, for example, to get the
right treatment rather thanjust fronting up to a pharmacy
and getting what they give you.
Speaker 2 (27:11):
Yes.
Speaker 1 (27:12):
Yes.
It is a bit of a bugbear foryou, yes, all right, it is a bit
of a bugbear for you, yes, allright, let's do this.
Speaker 2 (27:20):
This is something I'm like yes, let's get into this.
Yeah, because I do see it timeand time again where people have
gone oh, I've got itching, I'vegot a bit of discharge, I've
got a bit of discomfort, I'lljust go to the chemist.
Okay, that seems to havesettled down Not completely, but
we're okay.
Now, you know, a month later ora few weeks later, it happens
(27:41):
again.
They go back to their chemist.
If they've got a, if they'regoing to the same chemist, the
chemist might go.
No, actually, you might need togo and see your GP.
The GP might just still givethem that same treatment, or a
really good GP will actuallyswab.
That doesn't always happen, butwhen it does, it's gold,
because thrush isn't alwaysthrush.
(28:03):
So when there are recurrentsymptoms that are not being
treated, that are not going away, then we need to look deeper,
we need to look at what'sactually going on there, because
there are so many other issuesthat can occur in the vagina
that present really reallysimilar to thrush, that are not
(28:25):
actually thrush, and so thoseover-the-counter treatments for
thrush are just not going to cutit.
So you know, even eczema, youcan get eczema in the vagina.
I've got one client who we'vereally been able to sort that
out.
So as long as they don't eat aparticular food, they don't get
any symptoms, but as soon asthey do, they get a flare-up of
(28:48):
eczema not thrush.
But the only way you can tellthat was by swabbing.
And you know, yeah, anyway,going through all of that.
Um, bacterial vaginosis can canpresent really in a really
similar way.
Cytolibic vaginitis can presentin a really similar way, like
there's a whole list of thingsthat are really really similar
(29:11):
to thrush in that itching andirritation and painful urination
and discharge.
But without testing you don'tactually know.
So the GP can absolutely swab,and a lot of them do not always,
but a lot of them do and thatcan tell you what.
(29:32):
Because the other thing is,different types of candida can
be present and some differenttypes of candida actually need a
different type of treatment.
So yeah, so you want to makesure that we know what's there,
to know what we're treating.
Speaker 1 (29:47):
Yeah, and I guess that's what we're talking about.
How can women advocate forthemselves?
Is actually knowing to askcould you please swab, because
this has happened a few timesnow and what I'm doing clearly
is not working well enough.
Speaker 2 (30:00):
Yeah, that's exactly right.
Speaker 1 (30:03):
The fact that you know women actually have that
knowledge, to know that maybe Ijust need to nudge the GP a
little bit to get that testingdone, because maybe that's not
in their mind and particularlyif it's, you know, an
eight-minute consult and they'rejust trying to get through and
trying to find something to helpyou, which generally is just
going to be like a prescriptionyeah write a prescription that,
(30:24):
yeah, let's actually do um aswab and really get some good
information um.
So how do hormones impactthrush-like symptoms?
Speaker 2 (30:36):
So very similar to what I was talking about before.
So if estrogen is too high ortoo low, we see the changes in
the mucus and that then changesthe acidity, which changes the
environment.
Now, once we get to an aciditylevel that's too high, so too
(30:56):
alkaline, then microbes likecandida which is what causes
thrush microbes like candida,which are naturally occurring on
the surface of the skin, thenstart to.
We just get more of them and itgets too many, and that's when
you start to get the symptomsoccur.
And so what the creams aredesigned to do is they're
(31:18):
antifungal, so they're designedto kill off the excess fungus or
the excess candida, to be ableto bring everything back down to
normal, but all they're doingis treating that one event.
They're not looking at what'sgoing on underlying that.
So we want to make sure thatthose hormones are actually in
really nice balance as well, sothat we don't get this
(31:42):
recurrence, and that's whythrush can be quite cyclical.
So some women will get thrushat ovulation and just before
their period, when our estrogenlevels are really low, and other
women will get thrush justbefore ovulation and sort of
about a week before their period, which can be an indication
that estrogen levels areactually spiking too high and
(32:04):
that's actually changing thevaginal flora and the vaginal pH
.
So that's where you know we'retalking about pH testing.
Actually testing your pH levelscan tell you whether or not
those symptoms are likely tostart happening again.
Speaker 1 (32:19):
Amazing.
That is amazing.
And in terms of the vaginalmicrobiome influencing the
symptoms, can you talk a littleto that?
Speaker 2 (32:27):
Yeah, so when the lactobacilli are not in enough
quantity to be able to keep thatcandida levels under control,
that's when we start to see thathappening, and then, of course,
we need to make sure that it isactually candida, because as
those lactobacilli levels drop,it actually predisposes the
(32:48):
vagina to all sorts of otherpathogens as well.
So that's when you start to getthe discharge and the itching
and the smell and the irritation, depending on what's actually
ends up growing in thatenvironment that can influence
the type of discharge or thetype of smell or whatever it
might be, whatever thosesymptoms might be.
(33:10):
So, yeah, and there can bereally similar presentations
with completely different causes.
Speaker 1 (33:17):
Yeah, yeah, so interesting.
So what are some of these otherthings that can cause symptoms
that are similar and what canwomen do to prevent thrush
occurring or recurring, I shouldsay?
Speaker 2 (33:32):
Yeah.
So a couple of the things to doto prevent thrush recurring.
So we want to.
Cotton underwear is probablythe number one cotton or bamboo
underwear and go on commando.
So they're two of the thingsthat I often have my clients
doing and for someone that hasexperienced recurrent thrush or
(33:53):
you know other recurrentrentissues some of them I'll get
them to actually change theirunderwear, buy new underwear
every 12 months because we wantto prevent any build-up of
bacteria in the underwear line.
Drying clothes so washingclothes thoroughly and then
drying them in the sun canactually make a really big
difference, allowing the vaginato breathe and things like that
(34:18):
we were talking about earlier.
So not using like vaginalsanitation, I guess products.
The other thing is that ifsomeone's getting thrush I
forgot to mention this before ifsomeone's getting thrush and
they're using reusable menstrualproducts, oh yes.
So like period undies or, yeah,menstrual cups or menstrual
products, oh yes, so like periodundies or, um, yeah, menstrual
(34:39):
cups or menstrual discs andthey're finding that the thrush
symptoms are occurring towardsthe end of their period, they
need to um, sterilize and changethose menstrual products more
often.
So a lot of those menstrualreusable menstrual products are
designed to kind of go all daywithout having to change it, but
that actually changes the pH orthe acidity of the vaginal
(35:03):
microbiome and that can itselflead to symptoms.
So most products, if you go tothe website, there'll be a
sanitation process or a deepclean for period undies or, you
know, for menstrual cups andmenstrual discs.
It's pretty easy Wash it in amild soap and then boil it for a
minute or, you know, for 30seconds or something, and that
(35:26):
will sterilise that and changingmore often.
So if you're using a menstrualcup or a menstrual disc, you
know, change it every three orfour hours rather than going for
sort of 12 hours.
It makes a really big differenceto that as well.
Speaker 1 (35:39):
Yeah, yeah, amazing.
Such good advice and Alison.
I also wanted to talk aboutbacterial vaginosis.
Speaker 2 (35:53):
But I think we might come back and do another podcast
, because that is worth a wholepodcast.
Speaker 1 (35:55):
I know that's what I'm thinking.
That's what I'm thinking, andthere's been so much amazing
information from today and Ithink I'd like to get listeners
to absorb that, maybe evenlisten to this again, because a
lot of these concepts are goingto be new, and I think I
definitely want to get you backto talk about bacterial
vaginosis, or BV as we like tocall it, because, yeah, that's
(36:16):
something that I'm hearing a lotmore of.
I'm getting a lot more clientsthat have it and I think people
just women just need to knowmore about it yeah, yeah, I
think so too yeah awesome, allright.
So, alison, where can peoplefind you online if they'd like
to get in contact with you?
Speaker 2 (36:35):
Yeah, so if they look up the Vag Hormone Naturopath,
it's very long, I know, but yeah.
So thevaghormonenaturopathcomau is my
website, or on Insta or Facebookthe Vag Hormone Naturopath with
dots in between each word.
Book the Vag Hormone Naturopathwith dots in between each word,
(36:59):
and that, yeah, that's probablythe best way to find me.
From there you can find outmore about me, contact me, book
an appointment, whatever suits.
Speaker 1 (37:06):
Amazing and I know we were talking before we started
recording about a little ebookthat you have that's not
published, so not just anyonecan get it.
Can you talk a little bit aboutthat?
Speaker 2 (37:21):
That's right.
As of this moment.
It is an exclusive for yourlisteners because I haven't put
it anywhere else yet.
But yes, I do have an ebook onwhy over-the-counter thrush
treatments might not be working.
So if someone would like a copyof that ebook, dm me, send me
an email, hello at thevaghormonatropathcomau, and I'm
more than happy to send out acopy of that.
(37:42):
Yeah, and that's free of chargeright?
Speaker 1 (37:44):
Yes, absolutely, it is Awesome, Awesome, all right.
Well, alison, it has been likesuch a great podcast today.
I've been so excited to get allof this information out to my
listeners.
I really appreciate your time,so thank you so much for being
here.
Speaker 2 (38:02):
You're more than welcome.
Thanks, Susie.
Speaker 1 (38:05):
Thanks so much for joining me today on the Ageless
and Awesome podcast.
If you liked today's episode, Iwould love it if you could
write me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
Apple Podcasts, or the followbutton if you're on Spotify, so
that you can get each newepisode delivered to you every
(38:27):
week.
If you like free stuff, thenhead to the show notes and click
the link to receive my freeRadiant Reset guide for
perimenopausal women.
Now, this will only beavailable until the end of
January 2025.
So be quick.
If you'd like to continue thediscussion we've had today, head
over to Instagram and DM me, orfollow me at the perimenopause
(38:51):
path.
There's a little dot betweeneach word just to make it a
little bit more complicated, butI would love to connect with
you over there.
Hi, I'm Susie Garden and this is the Ageless and
Awesome podcast.
I'm an age-defying naturopathand clinical nutritionist and
I'm here to bust myths aroundwomen's health and aging so that
you can be ageless and awesomein your 40s, 50s and beyond.
The Ageless and Awesome podcastis dedicated to helping women
(00:24):
through perimenopause andmenopause with great health, a
positive mindset and outrageousconfidence.
Hit, subscribe or follow nowand let's get started.
Hello, gorgeous one, andwelcome to this week's episode
of the Ageless and Awesomepodcast.
I'm really excited abouttoday's episode.
It's a topic that I don't thinkI've covered in the years that
(00:48):
I've been doing this podcast.
I don't think I've reallycovered it ever in any great
depth, and that is the health ofthe vagina.
So I'm super happy and excitedto have a vagina expert here
today in Alison Patchett.
So Alison is the Vag HormoneNaturopath.
She's dedicated to empoweringher clients not only to manage
symptoms, but also to identifyand address the underlying cause
(01:11):
of those symptoms.
As you know, with naturopathywe love getting into that
underlying cause.
She's all about empoweringevery woman to feel informed and
confident about the health oftheir vagina and hormones,
providing expert integrativesupport for women, online or in
person.
She's based in Bandura inVictoria.
Alison addresses everythingfrom hormone imbalances to
(01:34):
intimate healthcare.
Her approach is tailored to herclients' needs.
She combines advanced testing,natural therapies and lifestyle
adjustments so you can reclaimyour health and get back your
sparkle.
Alison, welcome to the Agelessand Awesome podcast.
Speaker 2 (01:50):
Thank you, susie, it's lovely to be here.
Speaker 1 (01:53):
It's lovely to have you here as well.
I guess I wanted to start offwith a little bit about you and
your journey and how you came tobe interested in this area of
specialty, and maybe a littlebit even about the type of
training that you've done.
Speaker 2 (02:07):
Yeah, sure.
So being a naturopath is asecond career for me.
So I worked in the corporatespace for quite a long time and
saw a lot of very saw a lot ofmy colleagues get very burnt out
and was very burnt out myselfand so ended up following, I
think, what was a passion for areally long time in studying
naturopathy.
(02:29):
Then, after once I startedpracticing, I found that the
sort of people I was seeing Iwas seeing a lot of hormones, a
lot of women with menstrualissues, lots of PMS symptoms,
those sorts of things, and Ithink it was sort of I guess
when I was around 41, that Istarted to kind of look into my
(02:50):
own health a little bit more andstarted to see more of those
perimenopausal hormone clientscome in and then, starting to
see lots of vaginal issues,developed an interest in that,
studied a six-month coursecalled Vagiversity, which was
just amazing, which is a realdeep dive into what's going on
(03:13):
in the vagina and lots ofdifferent presentations and
symptoms and all sorts ofwonderful bits and pieces, and
found that that was a realcalling and a real passion to
really help women in this, Ithink, really underserviced area
of healthcare andunderappreciated as well.
Speaker 1 (03:35):
Yeah, yeah, absolutely, and this is
something that I see a lot.
I used to work in a localclinic here in the Gold Coast
and the intake form there wasincredible with the amount of
depth that went into withvaginal health questions and I
thought to myself, my gosh, whenI first saw it.
No GP has ever asked me any ofthose questions proactively, and
(04:01):
it's really something that manywomen are quite hesitant to
bring up.
There is still quite a lot ofstigma around the vagina.
I mean even just and I'm sureyou've had this probably on your
social media even writing theword vagina can be censored,
like I've.
I remember doing a story withthe automated captions and it
(04:24):
actually, you know, made alittle, I don't know an asterisk
or something where the A was.
It was just like what?
Why?
is this word being censored.
It's just crazy.
So no wonder women feel kind ofhesitant to bring these sorts
of symptoms to their healthcareprovider's attention.
When there is still that levelof embarrassment, would you
(04:44):
agree that is going on?
Speaker 2 (04:45):
in this area.
Oh, totally, yes, absolutely.
I think there's a realreluctance from many women to
kind of appreciate the extent towhich some of their vaginal
health issues are impactingtheir lives and their
relationships and theirself-confidence as well.
And you know, some of myclients, you know, will start on
(05:07):
one area and I do ask aboutvaginal health and then, you
know absolutely, will be led bythe client as to how comfortable
they are talking about it.
But you know, absolutely, if wehaven't touched on it before,
certainly within the second orthird consult we are talking
about vaginal health.
Certainly within the second orthird consult we are talking
about vaginal health.
It's something we're checkingon regularly, no matter what age
(05:28):
my client is, because it issuch an important area of
healthcare that is so oftenmissed.
Speaker 1 (05:36):
Absolutely, and there are a number of health issues
that can present, I guess, inthe vagina, particularly around
that perimenopausal time.
And that's a lot about whatwe're going to talk about today,
which I'm really excited to getinto, and I guess let's just
start with the probably morewell-known symptom of
perimenopause and postmenopause,which is the dry vagina.
(05:59):
So I guess I wanted to ask youfirstly.
So I guess I wanted to ask youfirstly, what are the most
common vaginal changes womenexperience during perimenopause?
Speaker 2 (06:11):
Yeah, so dryness is probably the number one issue
that people experience.
Irritation that then leads tothings like painful sex or even
painful masturbation, whichimpacts on libido.
(06:36):
We then have othercomorbidities, I guess, or other
symptoms that go along withthat, things like prolapse or
urinary tract infections,increased urinary frequency,
which is not necessarilytechnically the vagina, but
because of the location and thecrosstalk in that area.
We can see a lot of crossoverin symptoms and misunderstanding
of symptoms.
(06:57):
Because of the location.
You know where pain might occuror where irritation or itching
might occur, and so you know, asthose estrogen levels are
changing, that you know reallypromotes those symptoms to occur
.
Speaker 1 (07:14):
Can you talk to me a little bit more about the
misunderstanding of symptoms?
Speaker 2 (07:18):
Yeah, so what I find with actually, I had a client
last week we were talking about.
They felt like they were coming,they kept getting urine retract
infections, but they'd go tothe doctor, they'd do a urine
test.
It was nothing there, you know,there was nothing being cultured
and when.
So what we did was we reallytalked quite specifically about
(07:40):
the location of where thisirritation was occurring, and I
think we don't necessarilyappreciate how close some of
that anatomy is, and so,therefore, what was being
interpreted as urinary issueswas actually further back.
So it was actually the vaginathat was painful and irritated
(08:02):
rather than the urethra wherethe urine was coming out of.
And so it wasn't until we gotinto some really detailed
questions and, you know, broughtup diagrams and did all sorts
of things to kind of really getinto that nitty gritty detail
that we properly understood.
And for this client it was like, oh, of course that makes so
(08:23):
much sense now that they kind ofunderstood a little bit more
about what was going on, and youknow that meant that we could
actually move forward with anappropriate treatment plan
rather than kind of her feelinglike she had to keep, you know,
looking at potential antibioticsor other treatments that were
just not going to be effective.
Speaker 1 (08:43):
Yes, I know that's something that I'm seeing a lot
actually, just with my ownmother is the amount of
antibiotics that she's beingprescribed for recurrent urinary
tract infections and they'rejust not going any further in
terms of you know, theunderlying cause of that and I
think that is something that isa real problem, I think, in
(09:04):
women's health is that theamount of antibiotics that are
getting thrown at these sorts ofissues rather than going well.
Okay, come on, we know theunderlying cause, which we're
going to get into in a minute.
What are we going to do aboutthat?
So let's talk about why this ishappening.
What is the underlying cause?
Why are these changes happening?
Speaker 2 (09:23):
Yeah.
So I guess estrogen is kind ofthe main culprit good or bad.
Estrogen's awesome Loveestrogen.
Estrogen and progesterone, theyare so protective in so many
ways for our body and in ways wedon't even fathom, until we get
to perimenopause and thoselevels start to shift and we
(09:44):
start to see symptoms occurring.
And so what happens in thevagina is that estrogen actually
supports the production of a,an ingredient I guess, in the
mucus layer called glycogen, andwhat the glycogen does is it
(10:06):
helps support that mucus layerto be nice and healthy and that
then supports the beneficialbacteria in the vaginal
microbiome.
So yeah, so we might.
You know many people might haveheard of the gut microbiome.
Well, our vagina has amicrobiome as well and there's
one dominant species therecalled lactobacilli.
(10:27):
And so what estrogen does is itprovides the main food source
in the mucus for that.
So in perimenopause ourestrogen levels are kind of
going a little bit all over theplace, are kind of going a
little bit all over the place.
But certainly, as they start todecline we start to see that
mucus layer thin and thatimpacts the acidity of that
(10:51):
environment, it impacts theviscosity in there.
So I guess when we think of ourvagina.
We think of it as a hollow tube, which I guess it is, but when
it's in a relaxed state itactually sits flat.
So when we're not aroused orit's not being used in any way,
then the vagina actually sitsflat.
(11:11):
So when there's less mucus, thewalls of the vagina actually
rub against each other and thatcan cause irritation and that
can be quite painful, and sothat's kind of then leads to
further symptoms.
Speaker 1 (11:27):
Yeah, and so in terms of testing, I know you can test
the pH, for example, of thevagina and there's vaginal
microbiome testing.
Can you talk a little bit abouteach of those?
Speaker 2 (11:40):
Yeah, yeah.
So pH testing, I think, isincredibly.
It's a really easy way ofkeeping in touch with what's
going on in the microbiome.
So through perimenopause,because of those changes in the
mucus layer, we do see the pHmove from a more acidic pH of
between 3.5 and 4.5 and movesort of up to the higher end, up
(12:04):
to above 4.5, which is lessthan ideal, I guess.
And the vaginal pH test stripkits that you can get you can
get them online, you can getthem at some chemists.
That's a really good way ofbeing able to check in and see
what's going on in the vagina,because often what we see is the
presentation of symptomsfollows a rise in that vaginal
(12:26):
pH.
So that's actually for someonethat gets symptoms regularly,
that's actually a really niceway of kind of being able to
check and see what's going on ona more regular basis.
The vaginal test kit so there'squite a few different options
around, both here in Australiaand from overseas, and what
(12:48):
they're doing is often they arechecking the pH, but they're
going into a lot more detail.
So they're actually looking atthe flora that makes up that
vaginal microbiome.
So they're looking for thelactobacilli.
What type of lactobacilli?
They're looking for candidaspecies.
They're looking for otheropportunistic bacteria.
So if there are symptomsoccurring, so whether that's
(13:11):
itching or dryness or discharge,or smell or discomfort or
whatever it might be, we cantest that and we can see what's
going on more specifically, sowe can get to, we can be a lot
more targeted in the treatmentwhile we're addressing the root
cause of why that's happened inthe first place.
Speaker 1 (13:34):
Yeah, it's so good to have these tools available to
us, but generally you'reprobably not going to get
recommended to do that by the GP.
I think it's more thenaturopathic profession that's
kind of leading the way in thisaspect.
I mean, unfortunately, they arethings that you have to pay for
.
There's no Medicare coveragefor any of that kind of testing,
(13:56):
but it can make a bigdifference to have the knowledge
of exactly what you need tomanipulate, I guess, in the
microbiome, rather than justtaking a bit of a guess.
Yes absolutely yeah that'sabsolutely right.
Speaker 2 (14:11):
Yeah, I mean the more information you know.
Knowledge is power, so the moreinformation we have, the better
results that everyone's goingto get.
Speaker 1 (14:18):
Yeah, exactly, you're not going to waste, I guess,
time and money throwing thingsat it that maybe aren't going to
be as targeted and not going toget you that faster result.
And when you're talking aboutvaginal health, I mean it's very
uncomfortable to be havingthose sorts of irritated
symptoms.
I can imagine it'd be verydistracting probably a lot of
the time if you're at yourworkplace or you're trying to
(14:41):
enjoy life and you've got thesedistracting symptoms.
If you can get on top of it asquickly as possible, it really
improves quality of life, I canimagine, quite substantially.
Speaker 2 (14:52):
Yes, definitely, and I think for many women that put
up with those symptoms for sucha long time.
We don't want to muck around,we want to get on top of it.
Yeah, exactly.
Speaker 1 (15:01):
So you know, we've got these symptoms, we've got
the testing.
So what then?
Treatment options are availablespecifically for this, you know
, menopausal or perimenopausaldry vagina.
Speaker 2 (15:13):
Yeah, there's a couple of things that I use
quite regularly.
Sea buckthorn is something thatI use a lot of in this age
group.
I think it's such a it's abeautiful way of really being
able to support yourself, andwhat I really like about it is,
alongside other herbalinterventions, to look at what's
(15:33):
going on with, you know,supporting hormone balance and
things like that.
Sea buckthorn oil is somethingthat often my clients will use,
you know, daily for a couple ofmonths and then we'll start
tapering it back.
Speaker 1 (15:44):
Yeah, and that's applied into the area, right,
it's not?
Speaker 2 (15:47):
something you can take it orally.
Speaker 1 (15:48):
You can take it orally, so it depends on the
level of inflammation that'sgoing on.
Speaker 2 (15:52):
So sometimes I'll use fennel oil, like in a cream or
something like that, topically.
Sometimes we'll use the seabuckthorn oil topically and
orally.
So you know we might go okay,well, let's do your whatever
dose and, you know, do fivedrops and wipe that over the
vagina with a clean hand andtake the rest orally or whatever
it might be that suits thatparticular person and that
(16:13):
presentation, because that canmake a really big difference to
the itching and dryness and Ifind that working internally
while alongside of a hormonebalancing is just.
You know, it's a beautifulcombination that's really
settling.
I've also had a few clientsmake up their own flaxseed gel,
so I give them.
I've got a recipe that I giveto my clients.
(16:36):
Yeah, which is it's beautiful.
Actually, it can be usedtopically to kind of soothe
irritation and itching, but itcan also be used as a lubricant.
It can be used topically tokind of soothe irritation and
itching, but it can also be usedas a lubricant.
It can also be used as a hairgel, but most of my clients
don't use it for that.
It's more the lubricant and thesoothing aspect of it that
we're looking for.
But, yeah, it's a really nicething that they can make up
(16:59):
themselves at home.
Use this, you know, as theyneed it.
Yeah, and you know, obviously.
You know from a diet andlifestyle perspective.
You know we want to look atwhat's going on hygiene wise in
that area as well.
It's going to irritate thevagina, so we don't want any.
(17:29):
You know vaginal sprays orharsh soaps, or you know even
things like looking at what typeof underwear people are wearing
, or are they, you know, goingto the gym and getting really
sweaty but not changing theirclothes for a really long time
All of those sorts of littlebits and pieces make a really
big difference to how that areaof the body is actually feeling.
Speaker 1 (17:46):
Yeah and it's true, isn't it Like with the rise of
active wear as an all day kindof attire?
And, yes, I can imagine manywomen are going to the gym,
maybe particularly here inQueensland where it is very hot.
So you know even if you getchanged and have a shower, if
you're throwing active wear backon and it's you know they're
(18:07):
generally not made of naturalfibres and you're sweating
during the day, it's not reallya well.
Actually, it is an idealenvironment for not so good
bacteria to thrive and fungusand all of that sort of thing.
But yeah, I can imagine that'snot ideal and it's maybe not
something people are reallythinking about.
Speaker 2 (18:24):
Yeah, I think, yeah, I think there is often some
little changes that people canmake, like including flax seeds
in their diet, like wearingcotton underwear, like you know,
using water to clean theirvagina rather than any, you know
, special perfumes or whatever,or soaps, and those little
changes can make a really bigdifference.
Speaker 1 (18:46):
Do you find that many women are using different sort
of I'll call it chemicals,because that's generally what
they are in that area with aview to deodorizing or the
hygiene, that kind of thing?
Are you finding that there'scertainly?
I know we're probably a similarvintage.
As a teen and in my 20s thoseproducts didn't exist.
(19:08):
No, I know, you know it didn'texist.
It's not even a thought thatthat was a necessary kind of
product.
So you know, are you findingthat women are tending to use
that, or maybe it's more intheir 30s now that are probably
going to come into perimenopausein the next 10 years, that
might be using them more?
What are you finding?
Speaker 2 (19:27):
I think it's both.
I think what I find is thatwomen with vaginal dryness don't
necessarily recognize it asdryness.
They recognize it as itchingand irritation, and therefore
there's a lot of confusion overwhat is actually driving those
symptoms.
And therefore they're using youknow, they might be using
(19:48):
thrush treatments, or they mightbe using, you know, a body
spray or a you know, a vaginalcream that's, you know, just
from the chemist that's full offragrances and all sorts of
things that is actuallydisrupting the natural flora.
That's going on there and, andwhile some of them might provide
(20:10):
a little bit of short-termrelief, they're actually making
the problem worse in the longerterm yeah, yeah, because I guess
too, in fairness, like weprobably didn't even know that
the vaginal microbiome existedwhen those products first came
out.
Speaker 1 (20:26):
So yeah, and I think probably a lot of women still
don't know that we have aseparate microbiome down there
that needs to be looked after sothat you're getting kind of the
best health possible for yourvagina and for that longer-term
health as well.
Yeah, definitely, yeah.
So we've talked about treatmentoptions.
(20:48):
What about you know how canwomen advocate for themselves
when they're seeking help forvaginal symptoms?
Speaker 2 (20:54):
Yeah, I think this is a really big one for me and it
comes back to some of the thingsthat we were talking about you
know at the start of thisconversation about.
You know if your GP or yourhealthcare practitioner has
never asked about vaginal health, then you know that can make it
really really difficult forwomen to feel comfortable in
(21:17):
approaching that conversation.
So I think advocating foryourself is really about being
confident that you are theexpert on what's going on in
your body and that if a medicalpractitioner, no matter what
type of practitioner they are,if they dismiss those symptoms
(21:38):
without testing, withoutinvestigating, without asking
questions, then it's time tohave a look for another
practitioner, because we do needto take this seriously, you
know, as seriously as we take abroken arm or, you know,
whatever else might be acomplaint or a symptom that's
happening on the body is.
So many instances I hear ofwomen going to a healthcare
(22:03):
professional and being thrownsome cream with no, you know, no
testing, no questions kind ofasked, no detail being looked
into and of course that's notgoing to work.
So it's really about sayingthis is impacting me, this is
impacting me in these ways.
I need this taken seriously,absolutely, and having the
(22:25):
confidence in them that theyknow their own body better than
anyone else and really, yeah,that self-care aspect is really
about being confident to say Iknow what I'm talking about here
.
Speaker 1 (22:40):
Yeah, and you know, in defense of GPs, we know, and
they seem to be more openlytalking about the fact that, in
terms of menopause andperimenopause, in their entire
training they probably have onehour.
Oh, it's crazy, yeah.
So often they don't know whatto do.
Speaker 2 (22:58):
Yeah that's right.
That's right.
I mean, I have a female GPmyself and so she has asked
about vaginal health in the past, and so that opens up that
conversation.
But I've all equally spoken toclients who haven't had that
been fortunate enough to havethat conversation, but I've all
equally spoken to clients whohaven't been fortunate enough to
(23:18):
have that experience.
So it really is about findingthe right practitioner.
Speaker 1 (23:22):
It is and also, I guess, booking the right
appointment length, because Ithink that's another thing in
terms of how the GP works withtheir patients is they have a
very limited time and I'm veryexcited as we're recording this
podcast.
This week, the government hasannounced some very exciting
changes in the way menopausecare is being funded and that
(23:43):
they will be funding for longerconsults for menopause
discussions, which is great.
I mean, obviously you need tofind a GP that has menopause
training in order to actuallyget a solution, but as and also
saying that you know you're notnecessarily going to get
microbiome testing or pH testingfrom the GP, because they may
(24:04):
not just have that training.
So sometimes you need to haveboth type of practitioner to the
natural health practitionerthat has that training, uh, as
well as the medical practitioner, so that you can get kind of
both sides of the support thatmay be needed for that kind of
(24:26):
health.
Because, obviously naturopathsdon't do physical examination of
that area, so you know thereare some.
We don't do pap smears, wedon't do all of that sort of
stuff, so you do definitely needto have a practitioner that can
do that aspect.
But yeah, that's not.
So, yeah, having both.
I think if you've got the, findthe right one.
Speaker 2 (24:48):
It makes the world of difference.
And that's why I really lovewhat we do is because we work
hand in hand with whatever teamthat person's you know the
person sitting in front of usputs together.
We can work within that, thatscope.
You know there's so much.
You know I have clients who areon, you know, hrt or you know
(25:12):
doing all sorts ofpharmaceutical treatments, and
we can work really wellalongside that.
Equally, if someone doesn'twant to go down that path and
wants to try herbal supportfirst, then absolutely we can do
that.
It's about working in thecontext of what's right for that
person and there's no oneanswer to that.
Yeah, no matter what we'redoing, there's always room to
(25:35):
work side by side with GPs andgynecologists and you know
whoever else is on that person'smedical team for sure.
Speaker 1 (25:43):
Yeah, awesome, yeah.
And that's what I like to makereally clear, because I think
sometimes, as natural healthpractitioners, we can come
across as beinganti-conventional medicine, but
generally speaking, that is notthe case and, as you so
beautifully said, alison, we canwork hand in hand with whatever
team the client or the patientwould like to have on their team
(26:06):
, because the more, I guess,informed and educated
practitioners you have availableto you, hopefully you'll get
the ultimate outcome, which isoptimal health.
Yeah, so I wanted to change tacka little bit and let's talk
about thrush, because thrush is,I think, something that people
(26:28):
are more aware of.
I think they potentially aremore comfortable discussing it
because it does seem to besomething that's just so common
and many women have it at allstages of their life.
So if they've been havingepisodes of thrush since their
20s, it because it does seem tobe something that's just so
common and many women have it atall stages of their life.
So if they've been havingepisodes of thrush since their
20s, generally they're very,very comfortable going down to
the pharmacy and asking thepharmacist for treatment or
talking to their doctor.
I feel like that's probably,for whatever reason, has a bit
(26:50):
less stigma attached.
I don't know if that's yourexperience, but it seems to be
mine.
So if we can talk aboutrecurrent thrush, which does
start to occur in this age groupof peri and postmenopause, can
we talk about?
You know, the importance oftesting, for example, to get the
right treatment rather thanjust fronting up to a pharmacy
and getting what they give you.
Speaker 2 (27:11):
Yes.
Speaker 1 (27:12):
Yes.
It is a bit of a bugbear foryou, yes, all right, it is a bit
of a bugbear for you, yes, allright, let's do this.
Speaker 2 (27:20):
This is something I'm like yes, let's get into this.
Yeah, because I do see it timeand time again where people have
gone oh, I've got itching, I'vegot a bit of discharge, I've
got a bit of discomfort, I'lljust go to the chemist.
Okay, that seems to havesettled down Not completely, but
we're okay.
Now, you know, a month later ora few weeks later, it happens
(27:41):
again.
They go back to their chemist.
If they've got a, if they'regoing to the same chemist, the
chemist might go.
No, actually, you might need togo and see your GP.
The GP might just still givethem that same treatment, or a
really good GP will actuallyswab.
That doesn't always happen, butwhen it does, it's gold,
because thrush isn't alwaysthrush.
(28:03):
So when there are recurrentsymptoms that are not being
treated, that are not going away, then we need to look deeper,
we need to look at what'sactually going on there, because
there are so many other issuesthat can occur in the vagina
that present really reallysimilar to thrush, that are not
(28:25):
actually thrush, and so thoseover-the-counter treatments for
thrush are just not going to cutit.
So you know, even eczema, youcan get eczema in the vagina.
I've got one client who we'vereally been able to sort that
out.
So as long as they don't eat aparticular food, they don't get
any symptoms, but as soon asthey do, they get a flare-up of
(28:48):
eczema not thrush.
But the only way you can tellthat was by swabbing.
And you know, yeah, anyway,going through all of that.
Um, bacterial vaginosis can canpresent really in a really
similar way.
Cytolibic vaginitis can presentin a really similar way, like
there's a whole list of thingsthat are really really similar
(29:11):
to thrush in that itching andirritation and painful urination
and discharge.
But without testing you don'tactually know.
So the GP can absolutely swab,and a lot of them do not always,
but a lot of them do and thatcan tell you what.
(29:32):
Because the other thing is,different types of candida can
be present and some differenttypes of candida actually need a
different type of treatment.
So yeah, so you want to makesure that we know what's there,
to know what we're treating.
Speaker 1 (29:47):
Yeah, and I guess that's what we're talking about.
How can women advocate forthemselves?
Is actually knowing to askcould you please swab, because
this has happened a few timesnow and what I'm doing clearly
is not working well enough.
Speaker 2 (30:00):
Yeah, that's exactly right.
Speaker 1 (30:03):
The fact that you know women actually have that
knowledge, to know that maybe Ijust need to nudge the GP a
little bit to get that testingdone, because maybe that's not
in their mind and particularlyif it's, you know, an
eight-minute consult and they'rejust trying to get through and
trying to find something to helpyou, which generally is just
going to be like a prescriptionyeah write a prescription that,
(30:24):
yeah, let's actually do um aswab and really get some good
information um.
So how do hormones impactthrush-like symptoms?
Speaker 2 (30:36):
So very similar to what I was talking about before.
So if estrogen is too high ortoo low, we see the changes in
the mucus and that then changesthe acidity, which changes the
environment.
Now, once we get to an aciditylevel that's too high, so too
(30:56):
alkaline, then microbes likecandida which is what causes
thrush microbes like candida,which are naturally occurring on
the surface of the skin, thenstart to.
We just get more of them and itgets too many, and that's when
you start to get the symptomsoccur.
And so what the creams aredesigned to do is they're
(31:18):
antifungal, so they're designedto kill off the excess fungus or
the excess candida, to be ableto bring everything back down to
normal, but all they're doingis treating that one event.
They're not looking at what'sgoing on underlying that.
So we want to make sure thatthose hormones are actually in
really nice balance as well, sothat we don't get this
(31:42):
recurrence, and that's whythrush can be quite cyclical.
So some women will get thrushat ovulation and just before
their period, when our estrogenlevels are really low, and other
women will get thrush justbefore ovulation and sort of
about a week before their period, which can be an indication
that estrogen levels areactually spiking too high and
(32:04):
that's actually changing thevaginal flora and the vaginal pH
.
So that's where you know we'retalking about pH testing.
Actually testing your pH levelscan tell you whether or not
those symptoms are likely tostart happening again.
Speaker 1 (32:19):
Amazing.
That is amazing.
And in terms of the vaginalmicrobiome influencing the
symptoms, can you talk a littleto that?
Speaker 2 (32:27):
Yeah, so when the lactobacilli are not in enough
quantity to be able to keep thatcandida levels under control,
that's when we start to see thathappening, and then, of course,
we need to make sure that it isactually candida, because as
those lactobacilli levels drop,it actually predisposes the
(32:48):
vagina to all sorts of otherpathogens as well.
So that's when you start to getthe discharge and the itching
and the smell and the irritation, depending on what's actually
ends up growing in thatenvironment that can influence
the type of discharge or thetype of smell or whatever it
might be, whatever thosesymptoms might be.
(33:10):
So, yeah, and there can bereally similar presentations
with completely different causes.
Speaker 1 (33:17):
Yeah, yeah, so interesting.
So what are some of these otherthings that can cause symptoms
that are similar and what canwomen do to prevent thrush
occurring or recurring, I shouldsay?
Speaker 2 (33:32):
Yeah.
So a couple of the things to doto prevent thrush recurring.
So we want to.
Cotton underwear is probablythe number one cotton or bamboo
underwear and go on commando.
So they're two of the thingsthat I often have my clients
doing and for someone that hasexperienced recurrent thrush or
(33:53):
you know other recurrentrentissues some of them I'll get
them to actually change theirunderwear, buy new underwear
every 12 months because we wantto prevent any build-up of
bacteria in the underwear line.
Drying clothes so washingclothes thoroughly and then
drying them in the sun canactually make a really big
difference, allowing the vaginato breathe and things like that
(34:18):
we were talking about earlier.
So not using like vaginalsanitation, I guess products.
The other thing is that ifsomeone's getting thrush I
forgot to mention this before ifsomeone's getting thrush and
they're using reusable menstrualproducts, oh yes.
So like period undies or, yeah,menstrual cups or menstrual
products, oh yes, so like periodundies or, um, yeah, menstrual
(34:39):
cups or menstrual discs andthey're finding that the thrush
symptoms are occurring towardsthe end of their period, they
need to um, sterilize and changethose menstrual products more
often.
So a lot of those menstrualreusable menstrual products are
designed to kind of go all daywithout having to change it, but
that actually changes the pH orthe acidity of the vaginal
(35:03):
microbiome and that can itselflead to symptoms.
So most products, if you go tothe website, there'll be a
sanitation process or a deepclean for period undies or, you
know, for menstrual cups andmenstrual discs.
It's pretty easy Wash it in amild soap and then boil it for a
minute or, you know, for 30seconds or something, and that
(35:26):
will sterilise that and changingmore often.
So if you're using a menstrualcup or a menstrual disc, you
know, change it every three orfour hours rather than going for
sort of 12 hours.
It makes a really big differenceto that as well.
Speaker 1 (35:39):
Yeah, yeah, amazing.
Such good advice and Alison.
I also wanted to talk aboutbacterial vaginosis.
Speaker 2 (35:53):
But I think we might come back and do another podcast
, because that is worth a wholepodcast.
Speaker 1 (35:55):
I know that's what I'm thinking.
That's what I'm thinking, andthere's been so much amazing
information from today and Ithink I'd like to get listeners
to absorb that, maybe evenlisten to this again, because a
lot of these concepts are goingto be new, and I think I
definitely want to get you backto talk about bacterial
vaginosis, or BV as we like tocall it, because, yeah, that's
(36:16):
something that I'm hearing a lotmore of.
I'm getting a lot more clientsthat have it and I think people
just women just need to knowmore about it yeah, yeah, I
think so too yeah awesome, allright.
So, alison, where can peoplefind you online if they'd like
to get in contact with you?
Speaker 2 (36:35):
Yeah, so if they look up the Vag Hormone Naturopath,
it's very long, I know, but yeah.
So thevaghormonenaturopathcomau is my
website, or on Insta or Facebookthe Vag Hormone Naturopath with
dots in between each word.
Book the Vag Hormone Naturopathwith dots in between each word,
(36:59):
and that, yeah, that's probablythe best way to find me.
From there you can find outmore about me, contact me, book
an appointment, whatever suits.
Speaker 1 (37:06):
Amazing and I know we were talking before we started
recording about a little ebookthat you have that's not
published, so not just anyonecan get it.
Can you talk a little bit aboutthat?
Speaker 2 (37:21):
That's right.
As of this moment.
It is an exclusive for yourlisteners because I haven't put
it anywhere else yet.
But yes, I do have an ebook onwhy over-the-counter thrush
treatments might not be working.
So if someone would like a copyof that ebook, dm me, send me
an email, hello at thevaghormonatropathcomau, and I'm
more than happy to send out acopy of that.
(37:42):
Yeah, and that's free of chargeright?
Speaker 1 (37:44):
Yes, absolutely, it is Awesome, Awesome, all right.
Well, alison, it has been likesuch a great podcast today.
I've been so excited to get allof this information out to my
listeners.
I really appreciate your time,so thank you so much for being
here.
Speaker 2 (38:02):
You're more than welcome.
Thanks, Susie.
Speaker 1 (38:05):
Thanks so much for joining me today on the Ageless
and Awesome podcast.
If you liked today's episode, Iwould love it if you could
write me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
me a five-star review.
It makes me so happy.
Also, make sure you click thelittle plus button if you're on
Apple Podcasts, or the followbutton if you're on Spotify, so
that you can get each newepisode delivered to you every
(38:27):
week.
If you like free stuff, thenhead to the show notes and click
the link to receive my freeRadiant Reset guide for
perimenopausal women.
Now, this will only beavailable until the end of
January 2025.
So be quick.
If you'd like to continue thediscussion we've had today, head
over to Instagram and DM me, orfollow me at the perimenopause
(38:51):
path.
There's a little dot betweeneach word just to make it a
little bit more complicated, butI would love to connect with
you over there.
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